Madison Utilities Board votes to stop adding fluoride to public water, citing cost and regulatory uncertainty

MADISON CITY — The Madison Utilities Board voted March 17, 2025, to discontinue adding fluoride to the city’s public water supply, with the change scheduled to take effect June 16, 2025.

The board’s attorney, Woody Sanderson, told residents at a public meeting that the board made the decision after engineers identified roughly $450,000 in additional capital costs to add fluoride-handling systems to the King water treatment plant and because of employee safety and changing federal and state guidance. “The board has now chlorinated water for 35 years,” Sanderson said, adding the board voted to remove fluoride and proceed with the King Plant project without including a fluoride facility in that renovation.

The decision matters because fluoridation has been a public-health policy in the United States for decades and because local removal affects access to a fluoride delivery method that some health authorities say reduces tooth decay. Madison’s board said the choice is discretionary: no federal or state law currently obliges the utility to add fluoride, and the board relied on engineers’ estimates and legal advice in reaching its decision.

Board leaders and utility managers cited three practical reasons for the vote. First, engineers found significant fluoride-related corrosion and concluded retrofit work to relocate storage and dosing systems would be needed; preliminary estimates for that work were about $450,000. Second, staff raised employee safety concerns tied to handling concentrated fluoride and the required personal protective equipment and spill risks. Third, officials pointed to evolving regulatory and policy actions at the federal and state levels — including a recent federal court direction that EPA begin rulemaking on fluoride levels and several states moving to ban or restrict fluoridation — which created uncertainty about the long-term value of a retrofit.

Madison Utilities staff also noted changes in fluoride policy and use: the board first authorized fluoridation in 1990, implemented an approximate 1 milligram-per-liter dose in 1991, and lowered its dosing rate to 0.7 milligrams per liter after 2014. Presenters at the meeting said the U.S. Department of Health and Human Services and the Environmental Protection Agency have signaled renewed scrutiny of community water fluoridation, and they noted recent state actions in other states.

Staff presented technical details of the King plant layout and described a redesign that would move fluoride storage out of buildings occupied by staff and place two 300-gallon tanks in a new standalone chemical building connected by an underground line to an injection manhole. The engineers’ estimate for that work was the primary capital figure cited in the board’s deliberations.

Utility managers also described usage patterns they said reduce the efficiency of delivering fluoride by water: one presentation slide noted that in summer months about 60% of the water sold is used on lawns rather than consumed, and staff said bottled water and other fluoride sources — toothpaste, rinses, drops and clinical treatments — are more prevalent now than decades ago.

The board’s March vote followed public hearings earlier in May. A previously posted timeline from Madison Utilities noted a May 5 public meeting that drew dozens of speakers and a May 13 public hearing on fluoridation. Sanderson told the audience that the board provided the legally required 90-day notice to state regulators after its decision and that the hearing process would allow the board to consider additional public input before the change is implemented; he said the board could reverse course if it decided to do so after hearing public comments.

The utility emphasized that its operating revenues come from water and wastewater sales and fees, not from taxpayer general-fund dollars. Staff answered board questions about options for residents who do not want fluoride in their household water, saying the most common household removal method is a home reverse-osmosis system, and that individual alternatives such as fluoride drops or clinical treatments exist.

The board’s action was presented as a policy and engineering decision rather than an expression of settled medical consensus. Sanderson noted that scientific studies exist on both sides of the fluoridation debate and that historically the Centers for Disease Control and Prevention has revised its guidance on optimal community fluoride levels. He also warned that once added, fluoride is not easily or inexpensively removed from a public system.

Next steps listed at the meeting include continuing to accept public comment at scheduled hearings and allowing management to move forward with the King plant contract as awarded without fluoride-handling systems. The board’s materials said the contract award and plant design will proceed while the public-comment period continues.